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1184414880 NPI number — BIOMATRIX SPECIALTY INFUSION KS, LLC

NPI Number: 1184414880
Health Care Provider/Practitioner: BIOMATRIX SPECIALTY INFUSION KS, LLC

Information about “1184414880” NPI (BIOMATRIX SPECIALTY INFUSION KS, LLC) exists in 1184414880 in HTML format HTML  |  1184414880 in plain Text format TXT  |  1184414880 in PDF (Portable Document Format) PDF  |  1184414880 in an XML format XML  formats.

NPI Number : 1184414880 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184414880",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "BIOMATRIX SPECIALTY PHARMACY, LLC",
    "ParentOrgTIN": null,
    "OrgName": "BIOMATRIX SPECIALTY INFUSION KS, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "855 SW 78TH AVE # C200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLANTATION",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33324-3223",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "954-385-7322",
    "MailingAddressFaxNumber": "954-385-7324",
    "FirstLinePracticeLocationAddress": "6240 SPRINT PKWY STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OVERLAND PARK",
    "PracticeLocationAddressStateName": "KS",
    "PracticeLocationAddressPostalCode": "66211-1193",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-232-3072",
    "PracticeLocationAddressFaxNumber": "877-749-5015",
    "EnumerationDate": "05/07/2025",
    "LastUpdateDate": "11/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KRAMM",
    "AuthorizedOfficialFirstName": "EDWARD",
    "AuthorizedOfficialMiddleName": "P",
    "AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "913-515-6719",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251F00000X",
          "TaxonomyName": "Home Infusion Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "333600000X",
          "TaxonomyName": "Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336S0011X",
          "TaxonomyName": "Specialty Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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